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published quarterly by the Office of Perinatal Quality Improvement June 2011, VOLUME 66
University of Oklahoma Health Sciences Center
The S.T.A.B.L.E. Program Learner Course
July 20 - McAlester Regional Health System, McAlester
Aug. 2 - Muskogee Regional Medical Center, Muskogee
Dec. 5 - OPQI, Oklahoma City
AWHONN Intermediate Fetal Monitoring Course
Sept. 27 to 28 - St. John Medical Center, Owasso
Oct. 11 to 12 - OPQI, Oklahoma City
Nov. 1 to 2 - Comanche County Memorial Hospital, Lawton
AWHONN Advanced Fetal Monitoring Course
Aug. 3 - McAlester Regional Health System, McAlester
AWHONN Intermediate Instructor Course
July 26 - OPQI, Oklahoma City
NRP Instructor Training
Sept. 20 - OPQI, Oklahoma City
For a complete list of 2011 courses and registration,
Visit http://www.oumedicine.com/OPQI
Call (405) 271-7777 for more information.
New Edition of NRP Released
Emphasis on use of blended oxygen and pulse oximetry
The American Heart Association and American Academy of
Pediatrics have released the 6th edition of the Textbook of
Neonatal Resuscitation, the new textbook for the Neonatal
Resuscitation Program (NRP). The major changes with this
edition include the use of pulse oximetry in the delivery
room, delivery of blended oxygen, and changes in course
administration.
Pulse Oximetry in the Delivery Room – SPO2 monitoring
has been added to the NRP fl ow diagram anytime
a newborn requires positive-pressure ventilation
or is perceived to have persistent cyanosis. The
recommendation is to place an oximeter probe on the
newborn’s right palm or wrist. The textbook emphasizes
that cyanosis is normal in the fi rst few minutes after birth,
while the oxygen level is gradually increasing during
normal transition. If oxygen levels are rising as expected,
it may not be necessary to administer oxygen. See the
box (right) for normal values at various points during the
fi rst 10 minutes after birth.
Delivering Blended Oxygen – The previous edition of
NRP emphasized the benefi ts of blended oxygen to
premature infants and recommended blenders in the
delivery rooms of hospitals that routinely delivered
EDUCATION OPPORTUNITIES
Every Week Counts: Learning Session #2
July 22 - Oklahoma City
visit http://www.oumedicine.com/EWC
2011 OK ACOG Section Meeting
with Simulation for the Clinical Update
Oct. 6 to 7 - Oklahoma City
AAP National Conference and Exhibition
Oct. 15-18 - Boston
visit http://www.aap.org/nce
IN THE NEWS
FDA releases statement on Makena
ACOG releases Committee Opinion #494: Sul-fonamides,
Nitrofurantoin and Risk of Defects
Consumer Product Safety Commission Crib
Safety Standards go into eff ect June 28
Link to these stories and others at
www.oumedicine.com/opqinews
continued under “NRP,” page 2
OSDH Preparing for a Lifetime
Hospital-Based Activities
OPQI continues to facilitate 5 hospital based activities
in Oklahoma birthing hospitals:
Every Week Counts Collaborative
Abusive Head Trauma Prevention
Infant Safe Sleep Promotion
Smoking Cessation
Breastfeeding Promotion and Support
Please visit our web site at www.oumedicine.com/opqi
for updates, schedules and resources
OPQI STAFF:
Barbara O’Brien, RN, MS: Program Director
Warren M. Crosby, M.D.: Medical Director
Anne Wlodaver, M.D.: Prof. of Pediatrics
Chad Smith, M.D.: Assist. Prof. of OB/GYN
Denise Cole, RNC-NIC, MS: Coordinator
Barbara Koop, RNC-OB, MS: Coordinator
Courtney Hunter: Administrative Assistant
premature infants. The new edition recommends this for
all facilities that deliver babies. Administering oxygen
at variable concentrations rather than administering
pure (100%) oxygen gives the provider the ability to
try to mimic the normal gradual rise in oxyhemoglobin
(see box below). To achieve this, it is recommended to
increase or decrease the concentration of the oxygen
being administered based on the reading from the pulse
oximeter. For most facilities, this means new equipment
should be added to the delivery room: compressed air
and an oxygen blender. There are a variety of models of
Targeted Pre-ductal SPO2
After Birth
1 minute
2 minutes
3 minutes
4 minutes
5 minutes
10 minutes
60%-65%
65%-70%
70%-75%
75%-80%
80%-85%
85%-95%

published quarterly by the Office of Perinatal Quality Improvement June 2011, VOLUME 66
University of Oklahoma Health Sciences Center
The S.T.A.B.L.E. Program Learner Course
July 20 - McAlester Regional Health System, McAlester
Aug. 2 - Muskogee Regional Medical Center, Muskogee
Dec. 5 - OPQI, Oklahoma City
AWHONN Intermediate Fetal Monitoring Course
Sept. 27 to 28 - St. John Medical Center, Owasso
Oct. 11 to 12 - OPQI, Oklahoma City
Nov. 1 to 2 - Comanche County Memorial Hospital, Lawton
AWHONN Advanced Fetal Monitoring Course
Aug. 3 - McAlester Regional Health System, McAlester
AWHONN Intermediate Instructor Course
July 26 - OPQI, Oklahoma City
NRP Instructor Training
Sept. 20 - OPQI, Oklahoma City
For a complete list of 2011 courses and registration,
Visit http://www.oumedicine.com/OPQI
Call (405) 271-7777 for more information.
New Edition of NRP Released
Emphasis on use of blended oxygen and pulse oximetry
The American Heart Association and American Academy of
Pediatrics have released the 6th edition of the Textbook of
Neonatal Resuscitation, the new textbook for the Neonatal
Resuscitation Program (NRP). The major changes with this
edition include the use of pulse oximetry in the delivery
room, delivery of blended oxygen, and changes in course
administration.
Pulse Oximetry in the Delivery Room – SPO2 monitoring
has been added to the NRP fl ow diagram anytime
a newborn requires positive-pressure ventilation
or is perceived to have persistent cyanosis. The
recommendation is to place an oximeter probe on the
newborn’s right palm or wrist. The textbook emphasizes
that cyanosis is normal in the fi rst few minutes after birth,
while the oxygen level is gradually increasing during
normal transition. If oxygen levels are rising as expected,
it may not be necessary to administer oxygen. See the
box (right) for normal values at various points during the
fi rst 10 minutes after birth.
Delivering Blended Oxygen – The previous edition of
NRP emphasized the benefi ts of blended oxygen to
premature infants and recommended blenders in the
delivery rooms of hospitals that routinely delivered
EDUCATION OPPORTUNITIES
Every Week Counts: Learning Session #2
July 22 - Oklahoma City
visit http://www.oumedicine.com/EWC
2011 OK ACOG Section Meeting
with Simulation for the Clinical Update
Oct. 6 to 7 - Oklahoma City
AAP National Conference and Exhibition
Oct. 15-18 - Boston
visit http://www.aap.org/nce
IN THE NEWS
FDA releases statement on Makena
ACOG releases Committee Opinion #494: Sul-fonamides,
Nitrofurantoin and Risk of Defects
Consumer Product Safety Commission Crib
Safety Standards go into eff ect June 28
Link to these stories and others at
www.oumedicine.com/opqinews
continued under “NRP,” page 2
OSDH Preparing for a Lifetime
Hospital-Based Activities
OPQI continues to facilitate 5 hospital based activities
in Oklahoma birthing hospitals:
Every Week Counts Collaborative
Abusive Head Trauma Prevention
Infant Safe Sleep Promotion
Smoking Cessation
Breastfeeding Promotion and Support
Please visit our web site at www.oumedicine.com/opqi
for updates, schedules and resources
OPQI STAFF:
Barbara O’Brien, RN, MS: Program Director
Warren M. Crosby, M.D.: Medical Director
Anne Wlodaver, M.D.: Prof. of Pediatrics
Chad Smith, M.D.: Assist. Prof. of OB/GYN
Denise Cole, RNC-NIC, MS: Coordinator
Barbara Koop, RNC-OB, MS: Coordinator
Courtney Hunter: Administrative Assistant
premature infants. The new edition recommends this for
all facilities that deliver babies. Administering oxygen
at variable concentrations rather than administering
pure (100%) oxygen gives the provider the ability to
try to mimic the normal gradual rise in oxyhemoglobin
(see box below). To achieve this, it is recommended to
increase or decrease the concentration of the oxygen
being administered based on the reading from the pulse
oximeter. For most facilities, this means new equipment
should be added to the delivery room: compressed air
and an oxygen blender. There are a variety of models of
Targeted Pre-ductal SPO2
After Birth
1 minute
2 minutes
3 minutes
4 minutes
5 minutes
10 minutes
60%-65%
65%-70%
70%-75%
75%-80%
80%-85%
85%-95%